| Objective:Meta-analysis was used to analyze the effects of thyroxine replacement therapy on blood lipid levels and vascular atherosclerosis in SCH patients with different TSH levels,so as to provide evidence for the intervention time and clinical decision making of SCH treatment in clinical work.Methods:PubMed,the Cochrane library,EMBASE,CNKI,and WanFang were searched for target studies from inception by December,2019.According to the inclusion criteria and exclusion criteria that have been established,screening literature,data extracted and quality assessment.Then,meta-analysis by using stata14.0 software.Results:There were 11 RCT studies with 685 cases were included in our meta-analysis.The results showed that:①Thyroxine replacement therapy significantly reduced TC level compared with the control group[MD:-0.344;95%CI=[-0.646,-0.043];P=0.025].When TSH value was in the range of 4.2-7 μIU/ml,the TC level after l-t4 treatment significantly decreased[MD:-0.458;95%CI=[-0.743,-0.172];P=0.002].When the TSH value was 7.1-10 μIU/ml and greater than 10 μIU/ml,there’s no significant difference between L-T4treatment and the control group.[MD:-0.614;95%CI=[-1.306,0.077];P=0.082];[MD:-0.344;95%CI=[-0.287,0.433];P=0.690].②Compared with the control group,the LDL-C level of thyroxine replacement therapy was significantly reduced.[MD:-0.210;95%CI=[-0.300,-0.119];P=0.000].When TSH values were in the range of 4.2-7 and 7.1-10 μIU/ml,LDL-C level decreased after L-T4 treatment.[MD:-0.421;95%CI=[-0.669,-0.1721;P=0.0011;[MD:-0.196;95%CI=[-0.297,-0.095];P=0·000],when the TSH value in more than 10 μIU/ml,there’s no significant difference between L-T4 treatment and the control group.[MD:0.037;95%CI=[-0.308,0.381];P=0.836].③The influence of thyroxine replacement therapy on TG level was not significantly different from that of the control group.[MD:-0.126;95%CI=[-0.333,0.081];P=0.232].When TSH values were 4.2-7,7.1-10 and greater than 10 μIU/ml,there’s no significant difference between 1-t4 treatment and the control group.[MD:-0.128;95%CI=[-0.340,0.085];P=0.240];[MD:-0.216;95%CI=[-0.784,0.351];P=0.455];[MD:0.005;95%CI=[-0.224,0.235];P=0.963].④The effect of thyroxine replacement therapy on HDL-C level was not significantly different from that of the control group.[MD:-0.016;95%CI=[-0.134,0.102];P=0.789].When TSH values were 4.2-7μIU/ml,HDL-C level decreased after L-T4 treatment[MD:-0.095;95%CI=[-0.185,-0.005];P=0.038],When TSH values were 7.1-10 and greater than 10 μIU/ml,there’s no significant difference between l-t4 treatment and the control group.[MD:0.093;95%CI=[-0.171,0.357];P=0.491];[MD:0.020;95%CI=[-0.177,0.217];P=0.841].⑤The effect of thyroxine replacement therapy on CIMT was not significantly different from that of the control group.[MD:-0.02;95%CI=[-0.079,0.034];P=0.429].Conclusions:1.Thyroxine replacement therapy can significantly improve the levels of TC and LDL-C in SCH patients,and the treatment effect is more significant in patients with TSH≤7 μIU/ml,but there’s no significant effect on TG levels.HDL-C level decreased after L-T4 treatment in patients with TSH≤7 IU/ml,and no significant change in patients with other TSH level.2.Thyroxine replacement therapy had no significant effect on CIMT in patients with subclinical hypothyroidism. |
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